How much rates vary
Facilitymedian $1,995 · 10th to 90th $646 to $13,183Professionalmedian $1,995 · 10th to 90th $1,148 to $2,951
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $5,248.07 | Facility | None | $1,148.15 | $1,148.15 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,148.15 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,584.89 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,548.82 | $2,137.96 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,513.56 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,380.38 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,479.11 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,584.89 | $2,818.38 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $741.31 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $691.83 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $295.12 Typical High $660.69 | Professional | 80 · Assistant surgeon | $275.42 | $295.12 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $208.93 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $194.98 | $208.93 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $208.93 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $208.93 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $208.93 Typical High $467.74 | Professional | AS · PA/NP assist | $194.98 | $208.93 | $467.74 |
Where North Carolina sits
The same service costs 9.2 times more in Maine than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $22,965TX $2,508
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.